Neuropsychological diagnostic profiles of children who received CNS treatment for acute lymphoblastic leukemia: The systemic approach to assessment

A systemic developmental neuropsychological approach (Bernstein & Waber, 1990) was applied in a controlled fashion to evaluate its reliability and validity. Specifically, we examined the impact of central nervous system (CNS) treatment on behavioral development of children treated for acute lymphoblastic leukemia (ALL). A blind structured clinical rating procedure yielded severity ratings and neuropsychological diagnoses for 49 ALL patients and 15 Wilm's tumor (WT) patients. The ALL patients were more severely affected than the WT patients and females more affected than males. Neuropsychological diagnostic profiles were systematically related to age at CNS treatment: Children treated before 36 months of age exhibited inefficiencies of right‐hemisphere brain systems; those treated at older ages showed left‐hemisphere related inefficiencies. The findings are discussed in relation to processes of human postnatal neurobehavioral development, as well as to the status of the systemic approach.